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In Medicare Bull’s Eye: Lab Test Reimbursement

YOU CAN CONSIDER THIS ISSUE OF THE DARK REPORT TO BE an early warning of the escalating effort by public and private payers to rein in the “soaring cost” of clinical laboratory testing and anatomic pathology services. The intelligence briefings you will read on the following pag…

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Competitive Bidding: Once Again, It’s Back!

CEO SUMMARY: For the clinical lab industry, the concept of competitive bidding for Medicare Part B Clinical Lab Testing may be like the movie “Groundhog Day.” The hero, Bill Murray, kept reliving the same day over and over. So it seems to be with competitive bidding. In the latest rep…

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September 17, 2012 “Intelligence: Late Breaking Lab News”

Exome sequencing testing for cancer patients is now offered by the Cancer Genetics Laboratory at Baylor College of Medicine (BCM) in Houston, Texas. This clinical testing will be performed using next-generation gene sequencing technology. Pathologists at Baylor are among the first in…

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Employers, Payers Are Challenging ‘High’ Test Prices

ONE NATIONAL TREND IN CLINICAL LABORATORY TESTING that has not yet gotten wide play outside the pages of THE DARK REPORT is the emergence of what might be termed a “war” by national and regional health insurers against the “higher” prices often charged by hospital laboratories. This is a key…

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New BlueCard Policies Affect Lab Test Claims

CEO SUMMARY: This new policy from the Blue Cross and Blue Shield Association (BCBSA) becomes effective on October 14, 2012. No longer can a local lab provide service to a member under the BlueCard program and be paid by the local plan in the region where the service was provided….

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Blue Cross Execs Discuss Reasons for New Policies

CEO SUMMARY: In recent months, officials from the Blue Cross and Blue Shield Association (BCBSA) have responded to the concerns about new billing protocols for services provided as part of the BlueCard program and voiced by such clinical lab associations as the California Clinical Laborat…

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Lab Site Visits in NZ Show Impact of Lab Contracting

CEO SUMMARY: In some ways, the story of the New Zealand’s health system’s 15-year strategy to reduce the cost of clinical laboratory testing is a cautionary tale for public laboratory companies in the United States. During THE DARK REPORT’S site visit to several private labs in New …

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Cleveland Clinic Lab Aims to Grow Reference Testing

CEO SUMMARY: In the national market for reference and esoteric testing, Cleveland Clinic Laboratories (CCL) is preparing to expand its presence. It has just moved into a $75 million state-of-the-art laboratory facility and wants to increase its outreach reference testing by four-fold with…

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Health Insurers Now Finding Ways to Cut Costs and Shed Risks

CEO SUMMARY: Both employers and health insurers are taking aggressive steps to rein in healthcare costs. Several strategies to control spending and create powerful new incentives for providers are gaining favor. At this year’s Executive War College, Paul Mango of McKinsey & Company,…

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Executive War College Looks at Threats to Lab Industry

CEO SUMMARY: Taken collectively, the speakers at the opening session of the 17th Annual Executive War College on Lab and Pathology Management had a powerful message to the nearly 700 attendees. After years of slow movement, a rapid transformation of the American healthcare system is about…

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